A nurse on a medical unit is assigned patients with acid-base
irregularities. While caring for a patient with gastric lavage or prolonged
vomiting, the nurse should assess for: - ANSWER Metabolic alkalosis.
A client was diagnosed with "metabolic alkalosis" but the chart did not
include information on the history or physical exam. There was also no
lab data. Which of the following is a potential cause of metabolic
alkalosis? - ANSWER Hyperaldosteronism
A patient who is diagnosed with diabetes mellitus was ordered to have
an arterial blood gas (ABG). The attending physician suspects that the
patient is experiencing metabolic acidosis. Which set of arterial blood
gases should the nurse expect to find if the patient is having metabolic
acidosis? - ANSWER pH 7.29, pCO2 20, HCO3 14
A patient has an arterial blood gas done in the ER: pH 7.51, PCO2 49,
PO2 85, HCO3 35. Which of the following describes this ABG? -
ANSWER Partially compensated metabolic alkalosis
Of the following, which is most likely to cause respiratory acidosis? -
ANSWER Hypoventilation
The nurse reviews the following arterial blood gases and understands
that the patient has which acid-base imbalance?
pH 7.49, PCO2 41, HCO3 38 - ANSWER Uncompensated metabolic
alkalosis
A client with type 1 diabetes is in the ER after being found unconscious.
Upon assessment, the client's breath was noted to be fruity. Which of
the following ABG results would the nurse expect? - ANSWER pH 7.28
PCO2 40 HCO3 16
, A patient presents to the ER after being found unconscious and not
breathing. Before endotracheal intubation, you get an arterial blood gas
with which of the following results: - ANSWER pH 7.28 PCO2 60 HCO3
35
A patient is septic from an acute Clostridium difficile infection and
produces a higher than normal amount of lactic acid. Which of the
following is MOST likely to occur? - ANSWER Metabolic acidosis
The nurse draws a blood sample on an anxious patient that is
hyperventilating. The arterial blood gas will most likely show: -
ANSWER Respiratory alkalosis
A patient is having her first severe, acute asthma episode. It began 2
hours ago. What blood gas values should the nurse expect to see? -
ANSWER pH low, PaCO2 high, HCO3- normal
The nurse is assessing a patient who has diabetic ketoacidosis. Her
assessment reveals tachycardia, lethargy, and hyperventilation.
Treatment for the ketoacidosis has been initiated. What should the nurse
do about the hyperventilation? - ANSWER Lubricate the patient's lips
and allow continued hyperventilation.
The patient has severe metabolic alkalosis. Which intervention has the
highest priority? - ANSWER Raise the side rails on the patient's bed.
The nurse should ask which of the following questions to detect the risk
factors for metabolic acidosis? - ANSWER When did your kidneys stop
working?
How long have you had diarrhea?
Which weight loss diet are you using?
Which diagnosis indicates that the nurse should assess the patient most
carefully for development of metabolic acidosis? - ANSWER A
pancreatic fistula that is draining.
What is the most significant modifiable risk factor for the development of
impaired gas exchange? - ANSWER Tobacco use
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